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Dr. Andrew Rynne
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Dr. Andrew Rynne

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Exp 50 years

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I'm Prabhat, currently staying in XXXXXXX My wife is having

Answered by
Dr.
Dr. Elona Xhardo

Endocrinologist

Practicing since :2008

Answered : 792 Questions

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Posted on Tue, 5 Mar 2019 in Thyroid Problem and Hormonal Problems
Question: I'm Prabhat, currently staying in XXXXXXX My wife is having a thyroid problem since March 2018. Initially, it was hyperthyroidism with the values

T3 = 1.00 ng/mL

T4 = 6.06 μg/dL

TSH = 0.02 μIU/mL



and the Doctor prescribed Methimez 10Mg - 3 times per day. She continued the tablets for 2 months and went for Thyroid Profile test but it was not changed(improved). The Doctor suggested continuing the Methimez 10Mg 3 times per day and Prescribed two more D Rise XXXXXXX once in a month, Tricium Plus Tablet two times per day. Thereafter we do not follow up for 7 months. In XXXXXXX 2019 went for Thyroid Profile test changed to Hypothyroidism with the following TSH values

T3 = 0.41 ng/mL

T4 = 0.48 μg/dL

TSH = 187.40 μIU/mL



Immediately We went to another endocrinologist doctor. He said thyroid patients should follow up on regularly once every 2 months and prescribed the medicine and do the next follow up in 4-5 weeks.

Methimez 5 Mg once per day (1-0-0)

Eltroxin 75 mcg once per day (1-0-0)



My wife observed that there is a swelling in the neck feeling that left thyroid part is enlarged a little bit.

In Feb 2019, we went again for the Thyroid Profile Test and got the below values

T3 = 0.83 ng/mL

T4 = 6.72 μg/dL

TSH = 33.61 μIU/mL

and went to the doctor with the reports and we told regarding the neck swelling issue(left thyroid part). He said that no issue with the neck swelling and suggested continuing the same medicine for 2 more months



When we searched in google there is term Goiter swelling. Now we are afraid about this.

1. Please let me know, how to know whether she is having or not Goiter swelling?

2. Now she is having Hypothyroidism when this will be settled down permanently?

3. Is it fine to continue the medicine for 2 more months Methimez 5 Mg once per day (1-0-0) and Eltroxin 75 mcg once per day (1-0-0) for Hypothyroidism?
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Follow up: Dr. Elona Xhardo 0 minute later
I'm Prabhat, currently staying in XXXXXXX My wife is having a thyroid problem since March 2018. Initially, it was hyperthyroidism with the values

T3 = 1.00 ng/mL

T4 = 6.06 μg/dL

TSH = 0.02 μIU/mL



and the Doctor prescribed Methimez 10Mg - 3 times per day. She continued the tablets for 2 months and went for Thyroid Profile test but it was not changed(improved). The Doctor suggested continuing the Methimez 10Mg 3 times per day and Prescribed two more D Rise XXXXXXX once in a month, Tricium Plus Tablet two times per day. Thereafter we do not follow up for 7 months. In XXXXXXX 2019 went for Thyroid Profile test changed to Hypothyroidism with the following TSH values

T3 = 0.41 ng/mL

T4 = 0.48 μg/dL

TSH = 187.40 μIU/mL



Immediately We went to another endocrinologist doctor. He said thyroid patients should follow up on regularly once every 2 months and prescribed the medicine and do the next follow up in 4-5 weeks.

Methimez 5 Mg once per day (1-0-0)

Eltroxin 75 mcg once per day (1-0-0)



My wife observed that there is a swelling in the neck feeling that left thyroid part is enlarged a little bit.

In Feb 2019, we went again for the Thyroid Profile Test and got the below values

T3 = 0.83 ng/mL

T4 = 6.72 μg/dL

TSH = 33.61 μIU/mL

and went to the doctor with the reports and we told regarding the neck swelling issue(left thyroid part). He said that no issue with the neck swelling and suggested continuing the same medicine for 2 more months



When we searched in google there is term Goiter swelling. Now we are afraid about this.

1. Please let me know, how to know whether she is having or not Goiter swelling?

2. Now she is having Hypothyroidism when this will be settled down permanently?

3. Is it fine to continue the medicine for 2 more months Methimez 5 Mg once per day (1-0-0) and Eltroxin 75 mcg once per day (1-0-0) for Hypothyroidism?
doctor
Answered by Dr. Elona Xhardo 1 hour later
Brief Answer:
The hypothyroidism is not pemanent.

Detailed Answer:
hello
I have gone through your query and understood your concern.


The best approach for the treatement of Hyperthyroidism depends on your age, physical condition, the underlying cause of the hyperthyroidism, personal preference and the severity of your disorder.

Anti-thyroid medications(like Methimazole) gradually reduce symptoms of hyperthyroidism by preventing the thyroid gland from producing excess amounts of hormones.

It is very important to repeat the thyroid tests every 4-6 weeks,if you start anti-thyroid medications(like Methimazole).Antithyroid medications usually must be reduced; otherwise, the patient becomes hypothyroid.(like your wife's case)

Anyway to answer to your question,i suggest to do a thyroid ultrasound that will clarifie if the thyroid gland has increased in size and if has changed the ultrasound features.

The hypothyroidism is caused by the anti thyroid medication that is used for long time without decreasing the dosage.
This is not permanent and it the situation will stabilise soon,Don't worry.

If your wife was my patient,i will suggest to stop Methimazole for some weeks and to take only Eltroxin.
It is recommended to repeat the thyroid tests after 4 weeks to see the evoluation of the tests.


Hope this is helpful.
Let me know if i can assit you further.
Regards
Above answer was peer-reviewed by : Dr. Kampana
doctor
doctor
Answered by Dr. Elona Xhardo 0 minute later
Brief Answer:
The hypothyroidism is not pemanent.

Detailed Answer:
hello
I have gone through your query and understood your concern.


The best approach for the treatement of Hyperthyroidism depends on your age, physical condition, the underlying cause of the hyperthyroidism, personal preference and the severity of your disorder.

Anti-thyroid medications(like Methimazole) gradually reduce symptoms of hyperthyroidism by preventing the thyroid gland from producing excess amounts of hormones.

It is very important to repeat the thyroid tests every 4-6 weeks,if you start anti-thyroid medications(like Methimazole).Antithyroid medications usually must be reduced; otherwise, the patient becomes hypothyroid.(like your wife's case)

Anyway to answer to your question,i suggest to do a thyroid ultrasound that will clarifie if the thyroid gland has increased in size and if has changed the ultrasound features.

The hypothyroidism is caused by the anti thyroid medication that is used for long time without decreasing the dosage.
This is not permanent and it the situation will stabilise soon,Don't worry.

If your wife was my patient,i will suggest to stop Methimazole for some weeks and to take only Eltroxin.
It is recommended to repeat the thyroid tests after 4 weeks to see the evoluation of the tests.


Hope this is helpful.
Let me know if i can assit you further.
Regards
Above answer was peer-reviewed by : Dr. Kampana
doctor
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Follow up: Dr. Elona Xhardo 15 hours later
Thanks for the reply

I have two more questions

1. Meanwhile could you please let me know why she got swelling in the left part of the neck?
2. She is facing severe hair fall problem. What could be the reason for this or these are symptoms of thyroid?. Do you want to suggest any test for the hair fall? How to control hair fall if it is due to thyroid?
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Follow up: Dr. Elona Xhardo 0 minute later
Thanks for the reply

I have two more questions

1. Meanwhile could you please let me know why she got swelling in the left part of the neck?
2. She is facing severe hair fall problem. What could be the reason for this or these are symptoms of thyroid?. Do you want to suggest any test for the hair fall? How to control hair fall if it is due to thyroid?
doctor
Answered by Dr. Elona Xhardo 8 hours later
Brief Answer:
Hypothyroidism

Detailed Answer:
Hi again.

I need a recent thyroid ultrasound to understand what can be the exact thyroid diagnosis and the potential cause of actual neck swelling.

About the hair falling problem,in my opinion it can be attributed to severe hypothyroidism.
additional tests to exclude other causes of diffuse hair loss such as iron deficiency can be helpful.
Anyway with your wife's thyroid test results the cause of hair loss is evident.

When hypothyroidism will be resolved,even the hair fall will stop.
So,Levothyroxine(Eltroxin) is the solution.
I suggest to take 100 mcg Levothyroxine every day for 4 weeks.

Preferably have a varied and healthy diet, with calcium-rich foods and/or supplements taken 4 hours apart from your levothyroxine dosis.

Hope this is helpful.
Take care.
Above answer was peer-reviewed by : Dr. Kampana
doctor
doctor
Answered by Dr. Elona Xhardo 0 minute later
Brief Answer:
Hypothyroidism

Detailed Answer:
Hi again.

I need a recent thyroid ultrasound to understand what can be the exact thyroid diagnosis and the potential cause of actual neck swelling.

About the hair falling problem,in my opinion it can be attributed to severe hypothyroidism.
additional tests to exclude other causes of diffuse hair loss such as iron deficiency can be helpful.
Anyway with your wife's thyroid test results the cause of hair loss is evident.

When hypothyroidism will be resolved,even the hair fall will stop.
So,Levothyroxine(Eltroxin) is the solution.
I suggest to take 100 mcg Levothyroxine every day for 4 weeks.

Preferably have a varied and healthy diet, with calcium-rich foods and/or supplements taken 4 hours apart from your levothyroxine dosis.

Hope this is helpful.
Take care.
Above answer was peer-reviewed by : Dr. Kampana
doctor
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Follow up: Dr. Elona Xhardo 25 hours later
Hi Dr. Elona Xhardo,

Thanks for the reply

I have attached the Thyroid Ultrasound scannning reports. Please look into it and let me know the solution for swelling issue.

Now she is telling that difficult to swallowing the food.

Is this thryroid swelling issue can be resloved using medication?
If any extra medication required please let me know.
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Follow up: Dr. Elona Xhardo 0 minute later
Hi Dr. Elona Xhardo,

Thanks for the reply

I have attached the Thyroid Ultrasound scannning reports. Please look into it and let me know the solution for swelling issue.

Now she is telling that difficult to swallowing the food.

Is this thryroid swelling issue can be resloved using medication?
If any extra medication required please let me know.
doctor
Answered by Dr. Elona Xhardo 2 days later
Brief Answer:
Neck pain?

Detailed Answer:
Hi again .I appologise for the late reply.

I have rewied your attached reports.Considering the ultrasound report and the thyroid panel results i can deduct that your wife has a diffuse toxic goiter.This condition is also called Graves Disease.

The cause why she has neck swelling is not clear.
It can be a subacute thyroiditis that is happening parallely with your Graves Disease or sipmly the difuze goitre is enlarged.

Does she have neck pain,fever ,fatigue???
These symptoms can be related to a subacute thyroiditis .

Difficulty swallowing is suggestive of subaciute thyroiditis or a very large goiter.YOur wife has not a large goiter,considering the ultrasound results.

A neck examination and an elevated erythrocyte sedimentation rate (ESR) are helpful to do the differential diagnosis.

Only after the right diagnosis ,we can say what is the solution for your wife's neck swelling.

In these circumstances,My advice is to do the ERS test,and another ultrasound to see the actual structure of the gland espacially in the swelling area.

Let me know if i can assist you further.
Regards.
Above answer was peer-reviewed by : Dr. Nagamani Ng
doctor
doctor
Answered by Dr. Elona Xhardo 0 minute later
Brief Answer:
Neck pain?

Detailed Answer:
Hi again .I appologise for the late reply.

I have rewied your attached reports.Considering the ultrasound report and the thyroid panel results i can deduct that your wife has a diffuse toxic goiter.This condition is also called Graves Disease.

The cause why she has neck swelling is not clear.
It can be a subacute thyroiditis that is happening parallely with your Graves Disease or sipmly the difuze goitre is enlarged.

Does she have neck pain,fever ,fatigue???
These symptoms can be related to a subacute thyroiditis .

Difficulty swallowing is suggestive of subaciute thyroiditis or a very large goiter.YOur wife has not a large goiter,considering the ultrasound results.

A neck examination and an elevated erythrocyte sedimentation rate (ESR) are helpful to do the differential diagnosis.

Only after the right diagnosis ,we can say what is the solution for your wife's neck swelling.

In these circumstances,My advice is to do the ERS test,and another ultrasound to see the actual structure of the gland espacially in the swelling area.

Let me know if i can assist you further.
Regards.
Above answer was peer-reviewed by : Dr. Nagamani Ng
doctor
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Follow up: Dr. Elona Xhardo 48 hours later
Hi Dr. Elona Xhardo,

She does not have neck pain, fever, and fatigue.

Now she is facing issues with breathing difficulty, feels like food stuck in the throat while swallowing it, little enlargement in the neck like a lump and heavy hair fall.

Are these issues can be controlled through medications?

Sorry, at present I can't provide scan reports what you have asked again.
Please let me know if any other precautions need to be taken.

any suggested medications?
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Follow up: Dr. Elona Xhardo 0 minute later
Hi Dr. Elona Xhardo,

She does not have neck pain, fever, and fatigue.

Now she is facing issues with breathing difficulty, feels like food stuck in the throat while swallowing it, little enlargement in the neck like a lump and heavy hair fall.

Are these issues can be controlled through medications?

Sorry, at present I can't provide scan reports what you have asked again.
Please let me know if any other precautions need to be taken.

any suggested medications?
doctor
Answered by Dr. Elona Xhardo 1 hour later
Brief Answer:
YOur Wife has hypothyroidism symptoms.

Detailed Answer:
Hi again

From your description,i can deduct that your wife has symptoms of a large goiter that maybe compress the trachea and even the swalling tube (esophagus) leading to symptoms such as waking up from sleep feeling like you can't breathe, and the sensation that food is getting stuck in the upper throat.

Have hair fall is caused by hypothyroidism and the treatement with Eltroxin will stabilise the situation.

If your wife were me patient i will ask to to a thyroid scintigraphy and a CT of the neck to see if your wife has a retrosternal goiter or if the goiter comress the trachea.

Hope this is helpful.
Let me know if i can assist you further.
Best regards.




Above answer was peer-reviewed by : Dr. Yogesh D
doctor
doctor
Answered by Dr. Elona Xhardo 0 minute later
Brief Answer:
YOur Wife has hypothyroidism symptoms.

Detailed Answer:
Hi again

From your description,i can deduct that your wife has symptoms of a large goiter that maybe compress the trachea and even the swalling tube (esophagus) leading to symptoms such as waking up from sleep feeling like you can't breathe, and the sensation that food is getting stuck in the upper throat.

Have hair fall is caused by hypothyroidism and the treatement with Eltroxin will stabilise the situation.

If your wife were me patient i will ask to to a thyroid scintigraphy and a CT of the neck to see if your wife has a retrosternal goiter or if the goiter comress the trachea.

Hope this is helpful.
Let me know if i can assist you further.
Best regards.




Above answer was peer-reviewed by : Dr. Yogesh D
doctor
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